Origins of Fallopian Tube Cancer

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Dear OncoLink "Ask the Experts,"
Is there such a cancer as fallopian tube cancer? Or, is it ovarian cancer that starts in the fallopian tube?
Thank you,
F.

Ivor Benjamin, M.D., Former co-Editor-in-Chief, OncoLink, responds:

Dear F.
Thank you for your question and your interest.

Yes, there are several forms of cancer that may start in the Fallopian Tube. By far the most common variety is adenocarcinoma. More rare histologies (i.e. cell-types) include leiomyosarcoma or transitional cell carcinoma.

Overall, Fallopian Tube primary tumors (i.e. tumors that started in the tube) are uncommon and account for only 1-2% of all gynecologic cancers. The Fallopian Tube is a common site of metastasis (i.e. spread) from tumors that started in the ovary, uterus, endometrium, appendix or colon.

It is often difficult for the surgeon or the pathologist to reliably determine if an adenocarcinoma has started in the Fallopian Tube or the ovary. The reason is that the cells appear similar and the organs are in such close proximity to each other. For a clear diagnosis of Fallopian Tube cancer, the pathologist will look for an area of epithelium that shows a transition from normal to malignant cells that are in continuity. This implies that the tumor arose in the tube and was not a metastasis.

Feb 26, 2014 - Among women with mutations in BRCA1 or BRCA2, oophorectomy reduces the risk of developing ovarian, fallopian tube, or peritoneal cancer by 80 percent and reduces the risk of death by 77 percent, with greater BRCA1 benefit seen with earlier removal, according to a study published online Feb. 24 in the Journal of Clinical Oncology.